The CMS has shared the methodology behind its five-star hospital quality ratings to be published this April on Medicare's Hospital Compare website. The American Hospital Association gives the methodology a low score.
The ratings are meant to summarize complicated statistical data into “useful and easy-to-interpret” information for patients and consumers, the agency said Tuesday.
The AHA said the rating system “oversimplifies the complexity of delivering high-quality care” and should not be used. The association responded to the CMS document in an advisory to its members posted online Wednesday.
The overall hospital ratings will be the latest in the galaxy of stars federal health officials have posted over the past few years for various types of healthcare organizations, including home health and dialysis providers, and dual-demo and Medicare Advantage insurance plans. Most of those organizations have complained.
Last year, the CMS posted five-star ratings for hospitals based on patient-satisfaction scores derived from the survey known as HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems).
The summary rating for hospitals will not reflect all 113 quality measures already tracked on Hospital Compare, the CMS said in the document about its methodology. The full list was narrowed to a set of 62 measures focusing on seven key areas: mortality; safety; readmissions; patient experience; efficient use of imaging; and the timeliness and effectiveness of care.
The CMS said it excluded duplicate measures and those no longer required by other reporting systems, such as the inpatient and outpatient quality reporting programs. It also eliminated measures meant for specialty sites, such as cancer hospitals or inpatient psychiatric facilities.
The AHA, however, argued that measures of particular clinical services, such as cardiac care, provide a clearer picture for patients than a single summary rating.
“The model assumes that one can make a generalized judgment about a hospital's overall quality using available measures, even if those available measures do not encompass all aspects of quality,” the hospital association said in the advisory.
The CMS expects to post ratings for the 3,647 facilities that met reporting criteria, out of 4,604 facilities in the Hospital Compare dataset.
Just 87 of the qualifying hospitals earned five stars under the methodology, the CMS said, while 142 will get one star. About half (1,881) are right in the middle with three stars.
The CMS said the methodology reflects feedback from a test run, two public comment periods and stakeholder phone calls in 2015. Hospitals can confidentially preview their star rating using the CMS QualityNet portal.